https://www.stuvia.com/ HESI PN PHARMACOLOGY EXA M TEST BANK QUESTIONS & ANSWERS (NCLEX -PN) LATEST 1. 1) A nurse is caring for a client with hyperparat hyroidism and notes that the client's serum calcium l evel is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client? 1. Calcium chloride 2. Calcium gluconate 3. Calcitonin (Miacalcin) 4. Large doses of vitamin D: 3. Calcitonin (Miacalcin) Rationale: The no rmal se rum calcium l evel is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium gluconate and calcium chlo ride are medications used for the treatment of teta ny, which occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a t hyroid hormone, decreases the plasma calcium l evel by inhibiting bone reso rption and lowering the se rum calcium concent ration. 2. 2.) Oral i ron supplements are prescribed for a 6 -year-old child with i ron deficien cy anemia. The nurse instructs the mother to administer the iron with which best food item? 1. Milk 2. Water 3. Apple juice 4. Oran ge juice: 4. Orange juice Rationale: Vitamin C increases the abso rption of iron by the bod y. The mother should be instructed to administer the medication with a cit rus fruit or a juice that is high in vitamin C. Milk may affect abso rption of the iron. Water will not assist in abso rption. Orange juice contains a greater amount of vitamin C than apple juic e. https://www.stuvia.com/ 3. 3.) Salicylic acid is prescribe d for a client with a diagnosi s of psoriasis . The nurse monito rs the client, knowing that which of the following would indicate the presence of systemic t oxicity f rom this medication? 1. Tinnitus 2. Diarrhea 3. Constipation 4. Decreased respirations: 1. Tinnitus Rationale: Salicyli c acid is absorbe d readil y throug h the skin, and systemi c toxicity (salicylism ) can result. Symptoms include tinnitu s, dizzines s, hyperpnea, and psychological disturbance s. Constipation and diarrhea are not associated with salicylism. https://www.stuvia.com/ 4. 4.) The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most ef fective when applied: 1. Immediate ly before swimming 2. 15 mi nutes be fore exposure to the sun 3. Immediate ly before exposure to the sun 4. At least 30 minutes before exposure to the sun: 4. At least 30 minutes before exposure to the sun Rationale: Sunscreens are most ef fective when applied at least 30 mi nutes be fore exposure to the sun so that they can penet rate the skin. All sunscreens should be reapplied after swimming or sweating. 5. 5.) Mafenide acetat e (Sulfa mylon) is prescribe d for the client with a burn in- jury. When applying the medication, the client complains of local discom fort and burning. Which of the following is the most appropriate nursing action? 1. Notifying the registered nurse 2. Disconti nuing the medication 3. Informing the client that this is normal 4. Applying a thinner film than prescribed to the burn site: 3. Informing the client that this is no rmal Rationale: Mafenide acetate is bacte riostatic for gram-negati ve and gram-positi ve organisms and is used to treat burns to reduc e bacte ria present in avascula r tissue s. The client should be informed that the medication will cause local discom fort and burning and that this is a no rmal reaction; there fore options 1, 2, and 4 are incorrect 6. 6.) The burn client is receiving treatments of topical mafenide acetate (Sulfa mylon) to the site of injury. The nurse monito rs the client, knowing that which of the following indicates that a systemic ef fect has occurred? 1.Hype rventilation 2.Elevated blood pressure 3.Local pain at the burn site 4.Local rash at the burn site: 1.Hype rventilation Rationale: Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excre- tion of acid, there by causing acidosi s. Clients receiving this treatment should be monitored for signs of an acid-base imbalance (hyperventilation). If this occur s, the medication should be disconti nued for 1 to 2 d ays. Options 3 and 4 desc ribe local rather than systemic ef fects. An el evated blood pressure m ay be expected from the pain that occurs with a burn injury. https://www.stuvia.com/ 7. 7.) Isotretinoin is prescribed for a client with s evere acn e. Before the administratio n of this medication , the nurse anticipate s that which laborato ry test will be prescribed? 1. Platelet count 2. Triglyceride l evel 3. Complete blood count 4. White blood cell count: 2. Triglyce ride level Rationale: Isotretinoin can el evate triglyce ride levels. Blood t riglyce ride levels should be measured be fore treatment and pe riodically thereafter until the ef fect on the triglyce rides has been evaluated. Options 1, 3, and 4 do not need to be monitored specifically du ring this treatment. 8. 8.) A client with s evere acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client's med - ication reco rd and would contact the (HCP) if the client is taking whi ch medication? 1. Vitamin A 2. Digoxin (Lan oxin) 3. Furosemide (Lasix) 4. Phenytoin (Dilantin): 1. Vitamin A Rationale: Isotretinoi n is a metabolit e of vitami n A and can produc e gene ralized intensificatio n of isotretinoin t oxicity. Because of the potential for increased t oxicity, vitamin A supplements should be disconti nued before isotretinoin therapy. Options 2, 3, and 4 are not cont raindicated with the use of isotretinoin. 9. 9.) The nurse is app lying a topical co rticoste roid to a client with ec zema. The nurse would monitor for the potential for increased systemic absorption of the medication if the medication were being applied to whi ch of the following bo dy areas? 1. Back 2. Axilla 3. Soles of the feet 4. Palms of the hands: 2. Axilla Rationale: Topical co rticosteroids can be absorbed into the systemic circulation. Abso rption is higher from regions where the skin is especially pe rmeable (scal p, axilla, face, eyelids, neck, pe rineum, genitalia), and l ower from regions in which pe rmeability is poor (ba ck, palm s, soles).
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